Karen Jennings is one of the HPB nurses based in the Belfast Trust, covering the 3 sites of the Mater, the Royal, and the City Hospital and she looks after patients who have cancer in their pancreas area.
We asked Karen to share her advice for patients undergoing chemotherapy for pancreatic cancer, and their friends and family.
For lots of patients who have had a diagnosis of cancer when they hear the words chemotherapy it brings great fear to them, so, I’m going to discuss some of the things to look after yourself, how you can keep well when you’re having chemotherapy. Obviously, everyone is an individual so although these are very broad-spectrum things that everyone can do. Sometimes you will find that there are more individualised things that are also necessary as well,
But the first I would say is you need to concentrate on your eating and drinking.
Drinking is hugely important when you’ve had chemotherapy to try and get all of those toxins flushed out of your system. It would be important and if possible valuable to drink at least 2 litres of water a day - any fluids, it doesn’t really matter if it’s water; it could be juice, it could be tea, it could be coffee - whatever you can tolerate, just try and get the two litres in.
The other thing is eating. Lots of patients know and lots of people know when they hear the words chemotherapy that it can cause nausea and sometimes vomiting, so it would be very important that you eat. There are no special diets when it comes to therapy unless of course, you’re already on a special diet; you’re a celiac or maybe you’re a diabetic. Obviously, those are important to continue. But otherwise, you can eat whatever you want to eat, you don’t have to curtail it. The most important thing would be to eat whatever you feel that you can tolerate. Very often people find that they can’t eat 3 full meals a day. They can no longer tolerate a full breakfast, a full lunch and a full tea. Some people think that they find it’s easier to tolerate grazing throughout the day, so, they might have something to eat every couple of hours or every 3 hours just to try and keep their calorie intake up, and that’s fine too. Whatever way is best for you to get those calories and nutrition in. Whatever works best then that’s the way you do it
The other thing is when you come for chemotherapy, very often they will give you support medication. That can include things like steroids, it can include things like anti-diarrhoea tablets, anti-constipation tablets. All of those things are very important. They also include things like anti-sickness tablets, and we know from past patients, they sit at home and go “Oh, should I take those tablets or not?” If they are prescribed - and it will say very easily readable directions on the prescription. If you’re prescribed them don’t be sitting at home worrying about taking them. They’re not there to increase your anxiety, they’re there to manage your symptoms. So please take your tablets – if you’re prescribed them take them.
Another thing to think about is fatigue - probably one of the primary side-effects that we would hear about chemotherapy, all chemotherapy, not just those affecting pancreatic chemotherapies. So, one of the ways to counteract that fatigue is exercise and rest. Unfortunately, there are no magic pills to counteract that fatigue but research has proven that one of the ways you can counteract that is by exercise. By exercise, we mean walking. It’s not running marathons. It’s not climbing mountains. It’s walking, and nearly everyone can manage a walk So, for example, if you walked for half an hour before you started chemotherapy every day we would recommend that you continue to walk for half an hour every day while you’re on your chemotherapy. Some people find that they can’t manage half an hour in one go and that’s fine. You can break it up into three 10-minute sessions walk, or two 15-minute sessions of walk. Maybe you could do 10 minutes after your breakfast, 10 minutes after your lunch, 10 minutes after your tea - it’s manageable amounts of exercise. Try and get out of the house for your walking if possible. I know sometimes our weather isn’t always appropriate to go out, but try and get out because we know that the fresh air and the green around us does help for our mental health as well. If you can’t get out please walk around your house.
Equally, it’s important to rest. Very often people will set aside a time in the afternoon, they say “I’m going to rest this time”. It could be going to bed, it could be sitting down on their settee. Tell your family and your friends that you’re actually setting aside from 2 to 3 in the afternoon to rest so that people aren’t calling you, they’re not ringing you; they’re actually giving you time to rest and recharge those batteries for the rest of the day. I would also suggest that you set an alarm clock, or you tell one of your family members to wake you after that time because very often it would be easy to slip into a deep sleep, and then that can disrupt your evening and your sleep at bedtime.
And lastly one of the other things that we know is vitally important is looking after your mental and your emotional health. To get any cancer diagnosis is traumatic, both for yourself and loved ones around you and we know that in community there is lots of support from family and friends when you have this diagnosis; maybe from your church or the clubs that you attend - but sometimes those things aren’t enough. If they’re not enough please talk to someone, don’t hold it to yourself. We know that although friends are great, families are great, sometimes it’s great to have someone else to talk to that’s outside the family circle. That could be your GP, it could be the Consultant that you’re with, it could be one of the Nurse Specialists that’s helping look after you. Please lift up the phone and talk to someone because that is vitally important. You might need medication to stabilise your mood, to lift your mood. You might need counselling or sometimes you just need a listening ear just to get something off your chest. So, please contact all of those people or any of those people that will help.
The final point that I would make, and it’s probably one of the most critical points when you’re actually having chemotherapy and undergoing chemotherapy is the Helpline.
The Helpline is a 24-hour service carried out in the cancer centre and it operates 7 days a week, 52 weeks in the year. It doesn’t matter if it’s Christmas or not – it’s always available. It is a vital link when you’re having chemotherapy. We know that chemotherapy does cause some complications; some of them can be life-threatening and that’s the benefit of the Helpline. It is there to catch those symptoms and manage those symptoms before they become life-threatening. Please do not sit at home worrying “should I ring the helpline?”. If you have any concerns at all you pick up the phone and you ring. They will take your call. They will assess what needs to be done and they will get back to you.
Read more about chemotherapy here.